Is ELANE p.Arg78His (c.233G>A) pathogenic?

ELANE p.Arg78His (c.233G>A) is classified Uncertain significance in ELANE (ClinVar, Single submitter, 1 submitter; last evaluated 2026-01-01). AlphaMissense: likely benign (0.1677); Very rare (popmax 0.00596%, nfe); Associated with cyclic neutropenia.

What condition is associated with ELANE p.Arg78His (c.233G>A)?

ELANE p.Arg78His (c.233G>A) is associated with cyclic neutropenia, neutropenia, severe congenital, 1, autosomal dominant (ClinVar).

How common is ELANE p.Arg78His (c.233G>A) in the general population?

ELANE p.Arg78His (c.233G>A) is very rare (popmax 0.00596%, nfe) (gnomAD).

How is Cyclic neutropenia inherited?

Typically Autosomal dominant (Orphanet). A genetic counselor can assess individual risk for a family.

What do computational predictors say about ELANE p.Arg78His (c.233G>A)?

AlphaMissense predicts likely benign (score 0.1677) — an in-silico prediction, not a clinical call.

ELANE p.Arg78His

c.233G>A · rs569608929 · VCV1022943

Uncertain significance Single submitter

Classification

Uncertain significance

ClinVar

Review

Single submitter ★☆☆☆

ClinVar · 1 submitter

AlphaMissense

likely benign

0.1677 · ACMG-weighted

gnomAD v4.1

Rare

very rare (popmax 0.00596%, nfe)

Missense predictors

0/2 damaging

AlphaMissense, SaProt · REVEL no call

Conditions

cyclic neutropenia

Computational evidence

Protein change
AlphaMissense	0.1677	likely benign
REVEL	0.507	indeterminate
SaProt	LLR -9.57	tolerated
⇒ AlphaMissense and SaProt both call this tolerated; REVEL makes no call.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP -2.4	GERP -4
Regional constraint	o/e 1.04	unconstrained · MANE · 3,171 bp · p 0.52 · regional, not allelic
Overall
CADD	5.108	PHRED · no single calibrated threshold — expert panels disagree

ClinVar classifies this uncertain; the computational predictors unanimously lean tolerated — a triage signal, not a reclassification

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.00596% European (non-Finnish) · 70/1,175,106 alleles

Filtering AF 0.0048% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.0044%

Overall 0.00462% 74/1,602,138 alleles · very rare

Ancestry group	Frequency	1 in
European (non-Finnish)grpmax	0.00596%	16,787
Remaining individualsnot grpmax-eligible	0.00323%	30,932
East Asian	0.00226%	44,252
Admixed American	0.0017%	58,882

Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.

Variant & gene context

Gene: ELANE
Protein: p.Arg78His
Coding: c.233G>A
MANE Select: NM_001972
dbSNP: rs569608929
Type: single nucleotide variant
Location: chr19:853270 (GRCh38)
Gene constraint: LOEUF 1.245 · pLI <0.01 (gnomAD)
Structure: AlphaFold pLDDT 88.42 · 38 PDB
Residue 78: an α-helix; the peptidase s1 domain

Full ELANE gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

cyclic neutropenia — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: neutropenia, severe congenital, 1, autosomal dominant

For Cyclic neutropenia (Orphanet):

Inheritance: Autosomal dominant
Onset: All ages
Prevalence: 1-9 / 1 000 000 (Europe)

Similar variants

ELANE p.Arg78Leu Uncertain significance ★★ ⚠ same residue
ELANE p.Arg78Pro Uncertain significance ★★ ⚠ same residue
ELANE p.Arg78Ser Uncertain significance ★★ ⚠ same residue
ELANE p.Arg78= Likely benign ★ same residue
ELANE c.597+1G>A Pathogenic ★★ same condition
ELANE c.597+1G>C Pathogenic ★★ same condition
ELANE c.597+1G>T Pathogenic ★★ same condition
ELANE c.597+5G>A Pathogenic/Likely pathogenic ★★ same condition

Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →

Cite Sugi Variant

Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/elane-p-arg78his (accessed [today's date]).

Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown